先天性肾积水患儿β_2-MG、EGF、TGF-β_1含量变化及临床意义

Clinical value of the change of β_2-MG,EGF and TGF-β_1 in children with congenital hydronephrosis

目的探讨先天性肾积水患儿β2-微球蛋白(β2-MG)、表皮生长因子(EGF)及转化生长因子-β1 (TGF-β1)含量变化的临床意义。方法放射免疫法测定53例先天性肾积水患儿(肾积水组)血、尿β2-MG含量. 酶联免疫吸附法(ELISA法)测定其尿EGF及血、尿TGF-β1含量与20例正常儿童(正常对照组)测定结果比较。结果轻度肾积水尿β2-MG明显高于对照组;中、重度肾积水血、尿β2-MG、血、尿TGF-β1明显高于对照组,尿EGF明显低于对照组;各指标之间无显著相关性。结论尿β2-MG是反映肾小管功能的灵敏指标,尿β2-MG含量升高提示已存在肾小管功能损害。尿EGF为反映肾功能损害的可靠指标,但其灵敏度较尿β2-MG差;血β2- MG明显升高提示肾小球功能失代偿,血、尿TGF-β1为反映肾脏间质纤维化的可靠指标。

Objective To study the clinical value of the change of β2-MG,EGF and TGF-β1 in children with congenital hydronephrosis. Methods β2-MG in serum and urine in 53 children with congenital hydronephrosis and 20 healthy children were detected by radion immunoassays,while EGF in urine and TGF-β1 in serum and urine were detected by enzyme-linked immunosorbent assay. Results The level of β2-MG in urine in children with light hydronephrosis was obviously higher than that in healthy children. There were significant difference in the level of β2-MG in serum,EGF in urine and TGF-β1 in serum between the children with moderate or severe hydronephrosis and healthy children. There was no obvious correlationship among the different markers. Conclusion The level of β2-MG in urine is a sensitive marker to reflect the function of renal tubule. The level of β2-MG in urine significantly when the renal tubule is damaged. EGF in urine is a good marker to reflect the damage of renal function, but it is less sensitive than β2-MG in urine. β2-MG in serum increase significantly in children with moderate and severe hydronephrosis shows that the function of renal glomerulus is out of compensation. The level of TGF-β1 in serum and urine is a good marker to reflect interstitial fibrosis in kiney.